Objective
To investigate the impact of type II collagen (CII)–reactive T cells on the Th1/Th2 cytokine balance in patients with rheumatoid arthritis (RA).
Methods
T cell proliferative responses to bovine CII were examined in synovial fluid mononuclear cells (SFMC) and peripheral blood mononuclear cells (PBMC) by mixed lymphocyte culture. CII‐reactive T cell lines were generated from the SFMC and PBMC. Interferon‐γ (IFNγ), interleukin‐12 (IL‐12), and IL‐4 were measured by enzyme‐linked immunosorbent assay in the SF, sera, and culture supernatants of PBMC and SFMC that had been stimulated with CII.
Results
The frequency of CII‐reactive T cells was higher in the PBMC from RA patients than in that from osteoarthritis patients and healthy control subjects. In RA patients, CII‐reactive T cells were more prevalent in SFMC than in PBMC. The mean level of IFNγ and the ratio of IFNγ to IL‐4 were significantly higher in the culture supernatants of T cells stimulated with CII; these differences were more prominent in SFMC. Levels of IL‐12 in the culture supernatants of SFMC and PBMC stimulated with CII were significantly higher than those in unstimulated supernatants. T cell responsiveness correlated well with the level of type 1 cytokines in culture supernatants from RA T cells stimulated with CII. In the CII‐reactive cell lines, the increased production of IFNγ was consistent with clonal expansion.
Conclusion
CII‐reactive T cells are more abundant in SFMC than in PBMC and are strongly associated with a shift toward Th1 cytokine in the inflamed joints of RA patients. Our results suggest that a skewing toward type 1 cytokines by CII‐reactive T cells may play an important role in the chronic inflammatory process of RA.